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Study Results for 9 New Psoriatic Arthritis Drugs

Thomas R. Collins  |  June 21, 2018

CHICAGO—As Eric Ruderman, MD, professor of medicine in rheumatology at Northwestern University Feinberg School of Medicine in Chicago, began his talk on psoriatic arthritis treatment at the ACR State-of-the-Art Clinical Symposium in April, he marveled a bit at how much there was to cover. Drugs gaining prominence in the treatment of rheumatoid arthritis and dermatological…

When Is It Appropriate to Discontinue Bisphosphonates?

Thomas R. Collins  |  June 21, 2018

CHICAGO—A 75-year-old woman with low bone density, who has had a fracture and has other risk factors for fracture, is treated with the bisphosphonate alendronate. After five years on the drug she comes back, wondering: Should I stop taking the drug? She’s had no additional fractures. Her bone density has improved, but her lumbar spine…

Eosinophilia & Hypereosinophilia Diagnosis & Treatment Tips

Thomas R. Collins  |  June 21, 2018

CHICAGO—High eosinophil counts that can’t be explained should concern rheumatologists and spark attempts to identify what’s happening, an expert said at the ACR State-of-the-Art Clinical Symposium in April. “Eosinophil counts over 1,500 (per microliter) should provoke worry,” said Bruce Bochner, MD, professor of medicine in allergy and immunology at Northwestern University Feinberg School of Medicine…

Understanding & Treating Neonatal Lupus

Thomas R. Collins  |  June 21, 2018

CHICAGO—Neonatal lupus is a rare disorder, but its onset can be dramatic, and it can be fatal. Clinicians must be armed with information to manage it and help guide parents through difficult decisions, an expert said in April at the State-of-the-Art Clinical Symposium. Despite the name, neonatal lupus does not mean that either the mother…

Hydroxychloroquine Risk-Benefit Discussion, & a Handy Dosage App

Thomas R. Collins  |  June 21, 2018

CHICAGO—As good an option as hydroxychloroquine (HCQ) is for many patients with rheumatic diseases, such as rheumatoid arthritis and especially lupus, safety must be an important consideration, an expert said at this April’s ACR State-of-the-Art Clinical Symposium. The use of the antimalarial has become a controversial subject, with clinicians trying to balance the drug’s disease-modifying…

Precision Medicine for Lupus Continues to Progress

Thomas R. Collins  |  June 21, 2018

CHICAGO—The promise of precision medicine—the tailoring of treatment to a given patient based on genetics and other factors—has probably been best illustrated in oncology, with therapies targeted specifically to markers expressed on tumors. But rheumatology is in the thick of precision medicine as well, said Judith James, MD, PhD, chair of the arthritis and clinical…

Submassive pulmonary embolism. Filling defects seen in the pulmonary artery.

Case Report Illustrates Hypercoagulability in Behçet’s Disease

Aiza Tariq, MD, & Jasim Alidina, MD  |  June 21, 2018

Behçet’s disease is a chronic, relapsing and remitting vasculitis with multisystem involvement. Commonly referred to as the Silk Road disease due to its prevalence in the Asian and Mediterranean region of the traditional Silk Road, Behçet’s was first described by Hippocrates as a triad of symptoms—genital and oral ulcers with uveitis—and attributed to links with…

Can Rheumatologists Get More Systematic about Psychosocial Care?

Larry Beresford  |  June 21, 2018

A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…

Why & How to Pursue Shared Decision Making with Your Patients

Ruth Jessen Hickman, MD  |  June 21, 2018

Over the past several decades, the medical community has been moving toward a model of shared decision making. In addition to its ethical advantages, shared decision making potentially yields such benefits as improved medical adherence and better health outcomes. With the proliferation of treatment options and changes in the larger culture, shared decision making is…

Flare Risk Increases When Medication Is Stopped Prior to Arthroplasty

Vanessa Caceres  |  June 21, 2018

After total hip or knee arthroplasty, flares are common in patients with rheumatoid arthritis (RA), according to a recently published study.1 Higher disease activity at baseline appears to be linked to flares, but use of such medications as biologics and methotrexate did not independently predict flaring. “Contrary to the notion that patients with established RA…

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